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Test Code LAB6271 Mycobacteria and Nocardia Culture, Varies

Important Note

Mycobacteria and Nocardia Culture

Additional Codes

SQ: CTBM

Reporting Name

Mycobacterial Culture

Useful For

Detection and identification of Mycobacterium species, Nocardia species, and other aerobic actinomycetes

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Varies


Necessary Information


1. Specimen source is required.

2. Alert the laboratory if Mycobacterium genavense is suspected, as this species requires addition of mycobactin J to the culture medium for optimal growth and recovery.



Specimen Required


Submit only 1 of the following specimens:

 

Specimen Type: Body fluid

Container/Tube: Sterile container

Specimen Volume: 1.5 mL

 

Specimen Type: Bone marrow

Container/Tube: Sterile container, or green top (lithium or sodium heparin)

Specimen Volume: Entire collection

 

Specimen Type: Gastric washing

Container/Tube: Sterile container

Specimen Volume: 10 mL

Collection Instructions: Neutralize specimen within 4 hours of collection with 100 mg of sodium carbonate per 5 to 10 mL of gastric wash.

 

Specimen Type: Respiratory

Sources: Bronchoalveolar lavage fluid, bronchial washing, sputum

Container/Tube: Sterile container

Specimen Volume: 3 mL

Collection Instructions:

1. Collect 3 respiratory specimens for acid-fast smears and culture in patients with clinical and chest X-ray findings compatible with tuberculosis.

2. These 3 specimens should be collected at 8 to 24-hour intervals (24 hours when possible) and should include at least 1 first-morning specimen.

 

Specimen Type: Stool

Supplies: Stool Collection Kit, Random (T635)

Container/Tube: Sterile container

Specimen Volume: 5 to 10 g

 

Specimen Type: Tissue

Container/Tube: Sterile container

Specimen Volume: 5 to 10 mm

Collection Instructions: Collect a fresh tissue specimen.

 

Specimen Type: Urine

Container/Tube: Sterile container

Specimen Volume: 20 to 50 mL

Collection Instructions: Collect a random urine specimen.

 

Fresh tissue or body fluid is the preferred specimen type instead of a swab specimen. Recovery of mycobacteria from swabs is generally very low yield.

Specimen Type: Swab

Sources: Wound, tissue, or body fluid

Container/Tube: Culture transport swab (noncharcoal) culturette, or Eswab

Specimen Volume: Adequate specimen

Collection Instructions:

1. Before collecting specimen, wipe away any excessive amount of secretion and discharge, if appropriate.

2. Obtain secretions or fluid from source with sterile swab.

3. If smear and culture are requested or both a bacterial culture and mycobacterial culture are requested, collect a second swab to maximize test sensitivity.


Specimen Stability Information

Specimen Type Temperature Time
Varies Refrigerated (preferred) 7 days
  Ambient  7 days

Reference Values

Negative

Day(s) Performed

Monday through Sunday

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

87116-Mycobacterial Culture

87015-Mycobacteria Culture, Concentration (if appropriate)

87118-Id MALDI-TOF Mass Spec AFB (if appropriate)

87150-Id, Mtb Speciation, PCR (if appropriate)

87153-Mycobacteria Identification by Sequencing (if appropriate)

87176-Tissue Processing (if appropriate)

87150- Id, MTB complex Rapid PCR (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
CTB Mycobacterial Culture 543-9

 

Result ID Test Result Name Result LOINC Value
CTB Mycobacterial Culture 543-9

Testing Algorithm

When this test is ordered, a reflex test may be performed at an additional charge.

 

The following algorithms are available:

-Mycobacterium and Nocardia Culture Algorithm

-Meningitis/Encephalitis Panel Algorithm

Method Description

The BACTEC MGIT 960 System is a broth system designed for the rapid detection of mycobacteria in clinical specimens. Mycobacteria Growth Indicator Tubes (MGIT) are incubated for up to 42 days and growth is evaluated with mycobacteria identified as soon as a MGIT signals positive on the instrument.

 

In addition to the MGIT tube, Middlebrook 7H10/7H10S agar biplates are inoculated and incubated at 37° C for 42 days. Growth from positive MGITs or agar plates is identified using a variety of techniques as appropriate including rapid polymerase chain reaction, matrix assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry, or 500 basepair 16S rRNA gene sequencing.

 

The Mycobacterium tuberculosis complex will be identified to the species level upon request using rapid polymerase chain reaction.(Martin I, Pfyffer GE, Parrish N: Mycobacterium: General characteristics, laboratory detection and staining procedures. In: Carroll KC, Pfaller MA, Landry ML, et al, eds. Manual of Clinical Microbiology. 12th ed. Vol 1. ASM Press; 2019:558-575; Halse TA, Escuyer VE, Musser KA: Evaluation of a single tube multiplex real-time PCR for differentiation of the Mycobacterium tuberculosis complex in clinical specimens. J Clin Microbiol. 2011;49[7]:2562-2567. doi:10.1128/JCM.00467-11)

Report Available

42 to 70 days

Reject Due To

Blood or fixed tissue
Specimen in viral transport medium (including but not limited to M4, M5, BD viral transport media, thioglycolate broth)
Saliva
Swab sources of respiratory fluids (eg, sputum)
Swab sources of nasal, sinus, ear, mouth, throat, or scalp
Wood shaft or charcoal swab
Petri dish
Reject
 

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
ISMY ID by 16S Sequencing No, (Bill Only) No
RMALM Id MALDI-TOF Mass Spec AFB No, (Bill Only) No
RTBSP Id, Mtb Speciation, PCR No, (Bill Only) No
TBT Concentration, Mycobacteria No, (Bill Only) No
TISSR Tissue Processing No, (Bill Only) No
LCTB Id, MTB complex Rapid PCR No, (Bill Only) No

Specimen Minimum Volume

See Specimen Required

Method Name

Automated Detection of Positive Cultures followed by Organism Identification /DNA Sequencing/Matrix Assisted Laser Desorption/Ionization Time-of-Flight (MALDI-TOF) Mass Spectrometry

Forms

If not ordering electronically, complete, print, and send 1 of the following:

-Microbiology Test Request (T244)

-General Request (T239)

Secondary ID

8205